Psychopathology: The Bear's Embrace

Reactions Paper
PSY 546: Psychopathology
Kutztown University
Bill Schaeffer

The Bear’s Embrace
The Bear’s Embrace is a first person account of events after being a victim of a bear attack. Trish, the author, gave her story about the life challenges that include the physical, social, and psychological effects from the attack. The amount of vivid details of the attack and the after effects gives a full description of Post-Traumatic Stress Disorder.
My initial reaction when reading this story is that it seemed that it took a while until Trish was involved with mental health services. I understand it was important to stabilize her medically before worrying about long term effects, but the psychological effect of the attack

should have been accounted for earlier. It wasn’t until later that it was brought to Trish’s attention that she may have had Post Traumatic Stress Disorder. When looking at the DSM-5 it appears she met the criteria in many aspects. She 1) had exposure to an event that caused serious injury; 2) had intrusive symptoms, specifically recurrent memories of the events , flashbacks and intense psychological distress; 3) avoidance of the stimuli, specifically memories; 4) Negative alterations in cognitions and mood associated with the traumatic events, specifically persistent negative emotional state, markedly diminished interest in significant activities and persistent inability to experience positive emotions; 5)multiple marked alterations in arousal and reactivity associated with traumatic events ; 6) last for years; 7) caused significant distress and impairment in many aspects; 8) was not caused by a substance. So I am in agreeance with the PTSD diagnosis. Back to my original point, mental health services should have been implemented sooner. When Trish was having nightmares about the attack constantly the addition of services could have lessened some of the symptoms. I understand the diagnosis of Post-Traumatic Stress Disorder was not a major diagnosis at this time; her overall mental health should have been accounted for. Eventually Trish did receive treatment but it took many years to make progress until she was able to somewhat embrace the issue.
The next point that stood out to me was the amount of triggers she had from the attack. It appears that when Trish would obtain a medical procedure or struggled with a sickness it would be a trigger to her PTSD. Another trigger was anytime she was reminded of her changed appearance. This was extremely tough for her because anytime she would look in a mirror, or see people’s reactions it would be a reminder of such. At one point early on, it appeared that Trevor was somewhat of a trigger to Trish because of his physical features was a reminder of the events. Professionally I never worked with someone diagnosed with PTSD but it gave me some insight on the effects of such a disorder onto everyday life. She was constantly reminded of the effects of such an attack onto her life and was struggling to make psychological progress because of the prompts.
It also gave her perspectives of how her boyfriend Trevor was handling his thoughts about the attack. It appeared he was in denial for a large portion of the time, keeping busy and ignoring the issue. He then admitted he was also having the dreams that Trish was having. This was a portrayal of how people can handle mental health issues differently. He also described Trish as dwelling on the events too much but it seems as if he couldn’t understand how she was processing the events. Was he in denial about the fact that he was mauled by a bear? Or was it that he found an effective way to cope with the situation. Before he admitted to having the nightmares, I was expecting something major to occur to Trevor that would show his psychological effects from the attack. This sort of psychological breakdown was not noted in her story but it would not be surprising if he struggled with it more behind closed doors, away from others.
My other question was what were the effects of her constant infection in her head and the how it correlated with her mental health status throughout that time period.

Just processing the events of constant infection going through the body could have been a significant effect to her mindset. Did the infection actually effect her cognitive patterns as a reaction to the infection? Also her credibility with the doctors appeared to drop when she was explaining to them the abscess in her sinuses due to the bolts. How did this affect her relations with others to the effect of she knew what she was feeling but no one would listen to her or react accordingly for an extended amount of time. It was not until a doctor found the abscess and later took out the bolts in her face and found the damage it was causing. During that time period it could have damaged her mental status to the point that she felt like she was going crazy and could have exacerbated her other symptoms. My other concern is if there were side effects from all the prescribed drugs and medications that she had been taking for an extended period of time. For instance right after the attack it seems as if Trish was having hallucinations in the hospital. Could this have been a psychological effect from the attack? Maybe her body’s reaction to the amount of morphine she was on caused the hallucinations? Again there was no denial that she was struggling with the effects of PTSD but my curiosity is extended to the effects of

other factors that contributing to her suffering.
Overall the book gave an accurate depiction of the effects and struggles of someone that is affected by Post Traumatic Stress Disorder. It focused on the different aspects of physical, psychological, martial, and social effects of such traumatic events. It should be noted that even after the end of the book that the author had struggled with this disorder.
Prozac Nation
Prozac Nation is a story of a woman’s journey through her adolescence while struggling with depression or what she believes at the time was depression. She notes that her behaviors began as a pre-teenager and describes much of her background childhood information. It then navigates through her high school and college years and the numerous issues she had to endure during this time period. A lot of the time she was suffering was before the drug Prozac was created so a lot of her treatment was through therapy and other ineffective prescribed drugs before she found a drug that helped her break out of the state of depression she was lost in.
Throughout the book Elizabeth was constantly looking for a cause and/or escape from her depression. Her illness led her through summer camps, college, hiatuses to different states and countries, and mental health institutions. When reading the book it seemed as if her life consisted of a reoccurring cycle that consisted of depressive episodes, a relationship that somewhat uplifts her mood, the relationship becomes sabotaged, and then she returns to a major depressive state in which requires mental health treatment. My constant thought through the book was how many times she was going to continue through these similar patterns? It also seemed as if she was on a wild goose chase trying to identify her main underlying causes and triggers of her depression. She began describing her parent’s divorce, relationship issues with both of her parents, the pressures of college and then relationships that failed as potential triggers. All of which could have been trigger points but not the underlying reason for her depressive symptoms. She described early on that there was an extensive family history of mental health issues but did not return to that point as a major concern. This genetic factor is a component that was overlooked but could have been valuable information with future diagnosis of Elizabeth. It wasn’t until the later part of her journey that she could start identifying the significance of her mental illness onto the behaviors. Towards the end of her accounts Elizabeth stated she was diagnosed with Atypical Depression. I can agree she meets the criteria for Atypical Depression but it could be a more acute diagnosis for her now.
From my knowledge and referring to the DSM -5 I believe she is better diagnosed as Borderline Personality Disorder with the co-occurrence of Depressive Disorder with Atypical features. I didn’t gravitate towards this diagnosis just because the syllabus pointed out the theme for the reading, but her constant referral and anxieties of abandonment from different individuals stuck out to me. There were several instances of her begging individuals not to leave her or constantly trying to gain reassurance that a specific person would be there for her. It may have all started with her father’s abandonment and it could have set the precedence for future fear of abandonment. This ideation would then be a chicken and the egg continuum, does she have abandonment issues because of her personality or is it because of the complex dynamics of the relationship with her father that triggered such feelings; it is a predicament that mostly likely would not be answered. This continuum could be associated with each trigger associated with her issues.
The other criteria that sticks out to me is 1) patterns of unstable and intense interpersonal relationships which is described through her many relationships within the book; 2) Impulsivity that are potentially self-damaging, specifically sex and substance abuse; 3) Reoccurring suicidal behavior, gestures or threats, or self-mutilating behaviors; 4) Chronic feelings of emptiness, in which she describes many times throughout the whole book.

Adding the abandonment concerns and she meets the minimal criteria for the Borderline Personality Disorder diagnosis. Elizabeth’s numerous psychiatrists might not have known about her constant fear of abandonment, or might not have shown other symptoms for her to obtain the Borderline Personality Disorder diagnosis. A substance abuse diagnosis could also be possibly looked at from her extreme drug

use.
In the Epilogue of the book Elizabeth describes her current view of how anti-depressants are over prescribed and holds a huge threshold with the American culture. She also described the effects and essentially the cover up effect /not the cure of Prozac. Also during the Epilogue, I had the sense that she was bitter that Prozac was easily acceptable. It was almost giving the sense that people have not been through what she had to go through and they have the quick fix given to them. Whether her acknowledgement of such a pandemic is due to her resentment of having to live through a personal hell for many years, or she may be identifying a legitimate problem with the amount of anti-depressant prescriptions, either way anti-depressants are considered the modern treatment for many mental health disorders in conjunction with counseling.